FROM NEXT month people will start contributing to Gesy, the first phase of which, primary care, is set to be introduced on June 1, but the obstacles to its implementation are increasing rather than decreasing. In the latest setback, doctors are leaving the state hospitals and signing for Gesy because their earnings will be significantly higher. The boss of the government doctors’ union warned about the outflow of doctors and the failure of hospitals to replace them.
The reward system put in place by the Health Insurance Organisation (HIO) that has been rejected by most private doctors as derisory is very attractive to hospital doctors who could see their monthly earnings increase by as much 80 per cent if they set up their own practice and register a big enough number of patients. Of course, how many patients a doctor will have registered will depend on how many doctors sign up for Gesy – the more there are, the lower the earnings because patients will be more widely distributed among them.
This is not the only problem facing the under-staffed state hospitals. The contracts prepared by the state health services (Okypy) that will manage the hospitals have been rejected by both the nurses and doctors, who believe these offer no real incentive for them to give up their civil servant status, even though doctors were offered 14 per cent pay rise. Politicians and the media avoid taking a stand against the hospital doctors because they have already declared private doctors as the bad guys, Gesy’s number 1 enemy.
Leaving the communications games aside, there does not seem anyone capable of finding solutions to these problems and this is because no individual or agency has overall responsibility for Gesy. There is the HIO at war with private doctors and private clinics, Okypy trying to sweet-talk nurses and doctors into signing work contracts and the health ministry avoiding involvement so it is not blamed for the looming fiasco. All the stakeholders have dug in their heels holding out in order to get as much out of Gesy, money-wise, as possible.
The fact that the planning has been inadequate, the different agencies adopting the ‘we’ll improvise as we go along’ philosophy, makes it even more difficult to deal effectively with those fighting the scheme or trying to cash in on it. The HIO has done a good job winning the publicity war, blaming all problems, including its own slapdash planning, on the greed of private doctors, but getting a positive press will not facilitate the implementation of Gesy. Perhaps the mandarins of the health ministry, that have taken a back seat will eventually decide to become involved in what is happening and provide solutions, because as things are the prospects of introducing Gesy in June a looking very grim indeed.